What is Evidence Based Practice?

EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)

EBP Pyramid

Introduction to EBP

The best place for clinicians to get up to speed on unfamiliar topics and filling holes in their knowledge base. Several of these resources are (or act as) clinical textbooks with either brief or detailed entries on conditions and interventions. Keep an eye on currency; background resources are often a few years out of date.

These sources summarize the medical literature by finding (via explicit, thorough literature search) and appraising relevant individual studies to answer a particular clinical question. In most cases, clinicians should initiate a search for answers to clinical questions with the secondary literature. Please note that we have placed evidence-based guidelines into this category; the best clinical guidelines can provide an answer to a clinical question based on the best evidence. Again, keep an eye on currency.

Primary literature is where researchers publish their findings first. In the health field this is usually journal articles outlining methodology, data, results, and conclusions. The evidence based approach emphasizes a hierarchy of evidence based on study types. When searching for single studies on a topic, clinicians should utilize database tools (limits and filters) to obtain the highest level of evidence to answer a clinical question.